Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan.
Pacing Clin Electrophysiol. 2024 Aug;47(8):1073-1078. doi: 10.1111/pace.15026. Epub 2024 Jun 20.
Tachycardia-induced cardiomyopathy (TIC) is a reversible cardiomyopathy with ventricular dysfunction caused by tachyarrhythmias. Notably, atrial fibrillation (AF) is the most common causal arrhythmia leading to TIC. However, the risk factors for the development of TIC due to AF remain unclear. This study aimed to identify the associated factors of TIC due to AF.
Persistent AF patients with heart rate (HR) ≥100 beats per minute who underwent initial catheter ablation were enrolled in this study. TIC was diagnosed as left ventricular ejection fraction (LVEF) < 50% during AF rhythm, which was recovered after the restoration of sinus rhythm. Non-TIC was defined as LVEF ≥ 50% despite AF rhythm. The patient backgrounds were compared between the TIC group and the non-TIC group to reveal the contributing factors of TIC.
The TIC group comprised 57 patients, while the non-TIC group consisted of 101 patients. The TIC group was younger than the non-TIC group (median 64 vs. 70, p = 0.006). Male sex was more frequent in the TIC group than the non-TIC group (82.5% vs. 58.4%, p = 0.003). HR was higher in the TIC group than in the non-TIC group (median 130 bpm vs. 111 bpm, p < 0.001). The number of smokers was significantly higher in the TIC group than in the non-TIC group (p < 0.001). Multivariable analysis demonstrated that higher HR (odds ratio [OR]: 1.74; 95% confidence interval [CI]: 1.37-2.21; p < 0.001) and current smokers (OR: 5.27; 95% CI: 1.60-17.4; p = 0.006) were the independent factors leading to TIC.
Higher HR and current smokers were independent risk factors for the development of TIC due to AF.
心动过速性心肌病（TIC）是一种由心动过速引起的心室功能障碍的可逆性心肌病。值得注意的是，心房颤动（AF）是导致 TIC 最常见的因果性心律失常。然而，AF 导致 TIC 的发展的危险因素尚不清楚。本研究旨在确定 AF 导致 TIC 的相关因素。
本研究纳入了初始导管消融时心率（HR）≥100 次/分钟的持续性 AF 患者。TIC 的诊断标准为 AF 节律时左心室射血分数（LVEF）<50%，恢复窦性节律后恢复。非 TIC 定义为尽管有 AF 节律，但 LVEF≥50%。比较 TIC 组和非 TIC 组患者的背景，以揭示 TIC 的促成因素。
TIC 组 57 例，非 TIC 组 101 例。TIC 组患者年龄小于非 TIC 组（中位数 64 岁 vs. 70 岁，p=0.006）。TIC 组男性比例高于非 TIC 组（82.5% vs. 58.4%，p=0.003）。TIC 组 HR 高于非 TIC 组（中位数 130 次/分 vs. 111 次/分，p<0.001）。TIC 组吸烟者人数明显多于非 TIC 组（p<0.001）。多变量分析显示，较高的 HR（比值比[OR]：1.74；95%置信区间[CI]：1.37-2.21；p<0.001）和当前吸烟者（OR：5.27；95% CI：1.60-17.4；p=0.006）是导致 TIC 的独立因素。
较高的 HR 和当前吸烟者是 AF 导致 TIC 的独立危险因素。
